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Expert team performs Exploratory Laparotomy to help patient with
thickened descending colon, sigmoid colon and upper rectum

A 37-year-old male visited Nanavati Super Speciality Hospital, Mumbai with the chief complaint of pain in the left iliac fossa and passing of mucous and blood in stool for the past one year. He had visited other hospitals for the same problem where repeated Colonoscopies were done with no conclusive diagnosis.

The patient was admitted and started on IV fluids and antibiotics. Routine investigation results were all within normal limits. CEA levels were also found to be within normal limits. Clinically the patient was hemodynamically stable. He had tenderness in the left iliac fossa with

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lumpy feel. Rectal examination was performed which revealed irregular mucosa about 4cm from the anal verge.

CT scan of abdomen and pelvis suggested of thickened descending colon, sigmoid colon and upper rectum. The patient was managed conservatively and was discharged with directions to take oral antibiotics. However, the patient came back again with similar complaints after 15 days. Abdominal findings were the same as before. As per the rectal examination, previous irregularity of mucosa was not felt.

The patient was posted for Exploratory Laparotomy. There was evidence of thickened descending colon, sigmoid and upper rectum with tethered mesenteric. Resection of the involved segment was done, and descending colon was anastomosed to lower rectum.

Post-operative period was uneventful. Histopathology reports revealed ischemic colitis. Follow up result was also favourable, and the patient is now living a normal routine life. Segmental colonic ischemic stricture in a young patient without predisposing factors or co-morbidities is a rare entity. The patient is being referred to a haematologist to rule out hypercoagulable state.

Dr. Amol Joshi

Dr. Amol Joshi
Sr. Consultant
General & Laparoscopic
Surgery
Nanavati Super
Speciality Hospital,
Mumbai

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